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11th International Coeliac Symposium
           Thursday, April 29, 2004

The leprechauns of the skies continued to shine upon us today.  The sun rose
bright under a clear sky again, the temperature stayed pleasant and the wind
didn't blow us off the sidewalk.

It's a good thing the conference ends before Sunday because Belfast is going
to be a noisy place starting then.  We were served an advance sample of it at
lunch today.  Several musicians were testing a temporary band shell behind the
conference center with an impromptu performance for the office workers in the
area.  There are several more stages around the center of town for the music
festival and the streets are being marked for the marathon run.  With the
trees and flowers also in bloom, it must be spring in Belfast.

Today's sessions began with eight presentations on various aspects of the
epidemiology of and the screening for CD.  The studies presented indicated that
the lowest measured risk of celiac disease from the introduction of cereal
grains into the infant diet occurred between the age of 4 and 6 months, all first
degree relatives of celiac patients should be screened for celiac disease,
second degree relatives need not be screened for celiac disease unless they have
appropriate symptoms, and the cost and public health benefits of screening a
large general population for celiac disease may not be justifiable.

The second session of the day was a highly technical discussion of different
cells and immune systems in the human body and their interaction in celiac
disease.  T-cells, dendritic cells, mucosal cells and innate and adaptive immune
systems all come into play in celiac disease.  And while the knowledge base
keeps expanding daily, a complete understanding of the workings of the disease
remains elusive.

The technical examination of celiac disease continued into the afternoon with
three breakout workshops and a general session.  The workshops allowed 39 of
the papers submitted to the conference to be discussed in some detail.  A
brief summary of each paper was given, usually by the lead author, followed by a
short session of questions, answers, comments and suggestions from the audience.

The general session was an interesting counterpoint.  Seven  presentations
discussed cellular aspects of the inflammatory mechanism of celiac disease on
the gut in some detail.  In the eighth presentation, Per Brandtzaeg of Norway
suggested that the disease may not be an inflammatory condition at all - at
least not by the classical or typical definition.  For that, the blood vessels
must be involved and scarring would not be uncommon.  Instead, it appears that an
innate immune system mechanism is stimulating and magnifying an adaptive
immune system action.  The celiac iceberg appears to include nomenclature also.

The evening social event was a "Taste of Belfast" at the beautiful Europa
hotel.  The gala dinner preceded a demonstration of Irish dancing by a very
talented group of children and young adults.  The band then managed to get most of
the attendees to demonstrate their prowess at the band's version of Gaelic
line dancing.  Another fine example of Irish hospitality.

Thomas Sullivan                         Mary Schluckebier
President Elect CSA/USA          Executive Director CSA/USA


                                                       Diane Eve Paley
                                                       President CSA/USA

 Web site:csaceliacs.org
 toll free: 1-877/CSA-4CSA

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